The purpose of this competing continuation grant is twofold: a) to refine and expand the Nursing Interventions Classification (NIC) and b) to field test the Classification for clinical usefulness. The research will be accomplished in two phases. The specific phases and their objectives are: PHASE I: Refinement and expansion of the Nursing Interventions Classification (NIC) Objectives: 1. develop, implement, and evaluate an expert review process to evaluate feedback on specific interventions in NIC and to refine the interventions and classification as feedback indicates; 2. define and validate indirect care interventions; 3. refine, validate, and publish the taxonomic groupings for the interventions; 4. translate the Classification into a coding system that can be used for computerization, for articulation with other classifications, and for reimbursement. PHASE II: Field testing of the classification for clinical usefulness Objectives: 5. construct an electronic version of NIC to help agencies incorporate the Classification into nursing information systems; 6. implement and evaluate the use of the Classification in a nursing information system in four different agencies; 7. establish mechanisms to build nursing knowledge through the analysis of electronically retrievable clinical nursing data. Three retrospective investigations will: a) identify intervention clusters that typically occur together for certain types of patients; b) determine the use rate of particular interventions by type of unit and facility ("area variations"). c) identify core nursing diagnoses and outcomes for specific interventions. 8. publish a second edition of the Nursing Interventions Classification with taxonomic groupings and results of field testing. The central product of the grant work will be the publication of the second edition of NIC. This will include revised and new direct care interventions, new indirect care interventions, and all interventions ordered by logical groups (classes and domains). The revised Classification will also be coded for computer and reimbursement use. The results of the field testing will be written up and included with a discussion of the issues related to implementation. A preliminary list of related diagnoses and outcomes will be included for each intervention. The second edition of NIC will be available in both paper and electronic forms.